Local health departments, school nursing supervisors, school medical advisers, high school wrestling coaches Matthew Cartter, MD, MPH Lynn Sosa, MD Epidemiologist Epidemiologist February 15, 2013 SUBJECT: Information regarding Herpes Gladiatorum infections among high school wrestlers The Connecticut Department of Public Health (DPH) recently learned of skin infe
Frx.investorhq.businesswire.comForest '00 for pdf only 7/6/00 1:08 PM Page 8 drug most suitable for particular patients. Although different patients may respond differently to a particular SSRI in general, one SSRI may tend to be sedating and another may be activating or may cause gastrointestinal problems or sexual dysfunction. Celexa is usually well tolerated and has minimal side effects.
• Celexa has a favorable drug/drug interaction profile.
Celexa, a selective serotonin reuptake inhibitor (SSRI) One of the serious concerns physicians have to address in for the treatment of depression, was launched in prescribing drugs is the effect of the drug on other drugs the United States in September 1998. Its remarkable the patient may be taking. A drug may interfere with the success is evidenced by the following developments: metabolism of another drug, resulting in too high or too low a blood level of one of the drugs. Those changes, particularly in drugs with a narrow more prescriptions written for Celexa since it was launched than for any other SSRI during interfere with the metabolism and activity • Celexa has already attained over 12.2% of the new of other drugs. This can be particularly important for prescriptions for SSRI’s and its share of new prescriptions elderly patients who may be on multiple medications.
The second reason for Celexa’s success is Forest’s • Over 200,000 physicians have already prescribed effectiveness in communicating its characteristics to Celexa, and over 80% of them have prescribed it multiple physicians and other healthcare providers.
times and thousands of new physicians are prescribing Celexa every month.
• Approximately 2,500,000 patients have already been treated with Celexa in the United States since it was launched, and many more are being successfully treated every day. The reasons for Celexa’s success are two-fold: • Numerous clinical studies in tens of thousands of patients and widespread clinical experience have demonstrated that Celexa is a highly efficacious, first-line • Even before Celexa was launched, Forest was able to • Celexa has a favorable side effect profile. In many drug inform many leading physicians about its product categories it is often the side effects which determine the characteristics. Because Celexa had been widely used and Forest '00 for pdf only 7/6/00 1:08 PM Page 9 written about in Europe before Forest licensed it, there was a great deal of available clinical experience and published studies to use to inform American physicians.
• Forest entered into a co-promotion arrangement with Warner-Lambert in order to be able to visit the number of physicians with sufficient frequency to effectively compete in the heavily promoted SSRI category. Warner-Lambert agreed to provide 40% of the physician detail calls.
• As soon as Celexa was approved by the FDA, Forestdistributed 175,000 bottles of Celexa of thirty tablets each, sufficient for one month’s treatment, to 22,000 leading SSRI prescribers to encourage them to try the product on their patients, including those for whom other SSRI’s had not been successful, and for new patients. In many cases, physicians used Celexa on their most difficult patients and found that it was successful with those patients who had • At the launch and since then, Forest has maintained a competitive level of detailing and promotional activities consisting of professional advertising and educational physician programs, including symposia and other opportunities for researchers and clinicians to share their experience with other physicians. • Forest has been particularly successful in working withmanaged care organizations to assure patients’ early • Forest has continued to conduct a wide range of clinical studies to better define Celexa’s clinical use and increase physician awareness of its safety, effectiveness and favorable patient profile, including comparative studies Celexa’s clinical virtues and Forest’s continued support will assure Celexa’s growth and broad usage Forest '00 for pdf only 7/6/00 1:08 PM Page 10 In November 1999, Forest learned that Warner-Lambert, co-promotion payments would more than offset the its co-promotion partner, would merge with either American Home Products or Pfizer, both of which In order to accomplish such a large expansion market antidepressants that are competitive with Celexa.
so quickly, Forest’s sales team adopted a highly Forest recognized immediately that Warner-Lambert focused strategic approach. Forest promptly arranged would not be able to continue marketing Celexa once with a contract sales organization, with national recruiting a merger was completed. Forest rapidly evaluated its capability, to begin identifying candidates for alternatives and concluded that the most favorable course of action would be to expand its own salesforce and While Forest had previously carried out expansions of its salesforce in connection with the launch of Tiazac and Celexa, the imminent loss of support from Warner- Lambert in the highly competitive SSRI market clearly required expansion at a level that Forest had not undertaken before. After a careful analysis of the number of physicians Forest had to call on and the frequency with which those calls had to be made to be competitive with the other SSRI’s, it was determined that 575 new representatives would be needed. Forest also decided that this 70% increase in its salesforce would have to be completed in just four months to ensure that the new representatives were hired, trained and in the field prior to the termination of the co-promotion Although the incremental costs of hiring so many representatives while still paying Warner-Lambert its co-promotion fees were expected to have a short-term adverse effect on Forest’s earnings, it was felt that the continued uninterrupted growth of Celexa was critical to Forest’s long-term success. Forest also recognized that by expanding its salesforce immediately, rather than in 2001 when the co-promotion of Celexa by Warner-Lambert was scheduled to terminate, the savings of future Forest '00 for pdf only 7/6/00 1:08 PM Page 11 employment. Forest’s sales managers developed the new representatives. Manager assessment centers were a screening and interviewing process to expedite formed throughout the U.S. to interview, evaluate and select personnel for promotion to manager, trainer and Recruiting and selection occurred while Forest specialty sales positions. In total, over 200 Forest completed the development of a new territory structure.
sales employees, approximately 25% of sales employees at Forest’s sales administration group utilized sophisticated that time, were promoted and trained for positions territory mapping software to delineate specific sales of greater responsibility in just two months.
territories for the expanded salesforce. Based on the By April 2000, Forest had completed its recruitment number of doctors to be seen and the frequency of calls project and hired and trained the additional required, three salesforces were formed: two large general representatives. The result is that Forest now has salesforces and a smaller specialty salesforce to call on 1,425 representatives and managers providing sales calls to physicians for Celexa and Forest’s other promoted Forest’s sales training department was rapidly products. Activity on all of Forest’s products has expanded and an intense training program was developed increased significantly and Forest, on its own, is already for both new managers and representatives. Outside providing more sales calls on Celexa than Forest and training facilities were arranged to accommodate the Warner-Lambert combined prior to the expansion. This large numbers of new representatives and trainers.
expanded salesforce will assure Celexa’s continued A crucial element of the expansion was identifying growth and will allow Forest to continue to add new existing experienced sales personnel to manage and train important products to its portfolio.
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